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https://www.readbyqxmd.com/read/29166543/transcatheter-or-surgical-aortic-valve-replacement-in-patients-with-advanced-kidney-disease-a-propensity-score-matched-analysis
#1
Rajkumar Doshi, Jay Shah, Vaibhav Patel, Varun Jauhar, Perwaiz Meraj
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is an alternative for surgically inoperable patients with severe aortic stenosis. Advanced kidney disease may significantly affect outcomes in patients treated with TAVR and surgical aortic valve replacement (SAVR). HYPOTHESIS: TAVR is associated with better in-hospital outcomes compared with SAVR in patients with advanced kidney disease. METHODS: We identified our sample from the National Inpatient Sample between 2012 and 2014, using International Classification of Diseases, Ninth Revision, Clinical Modification codes...
November 22, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/29162345/postacute-care-after-pediatric-hospitalizations-for-a-primary-mental-health-condition
#2
James C Gay, Bonnie T Zima, Tumaini R Coker, Stephanie K Doupnik, Matthew Hall, Jonathan Rodean, Margaret O'Neill, Rustin Morse, Kris P Rehm, Jay G Berry, Naomi S Bardach
OBJECTIVES: To determine the proportion of US children hospitalized for a primary mental health condition who are discharged to postacute care (PAC); whether PAC discharge is associated with demographic, clinical, and hospital characteristics; and whether PAC use varies by state. STUDY DESIGN: Retrospective cohort study of a nationally representative sample of US acute care hospitalizations for children ages 2-20 years with a primary mental health diagnosis, using the 2009 and 2012 Kids' Inpatient Databases...
November 18, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29155982/economic-and-survival-burden-of-dysphagia-among-inpatients-in-the-united-states
#3
D A Patel, S Krishnaswami, E Steger, E Conover, M F Vaezi, M R Ciucci, D O Francis
The inpatient burden of dysphagia has primarily been evaluated in patients with stroke. It is unclear whether dysphagia, irrespective of cause, is associated with worse clinical outcomes and higher costs compared to inpatients with similar demographic, hospital, and clinical characteristics without dysphagia. The aim of this study is to assess how a dysphagia diagnosis affects length of hospital stay (LOS), costs, discharge disposition, and in-hospital mortality among adult US inpatients. Annual and overall dysphagia prevalence, LOS, hospital charges, inpatient care costs, discharge disposition, and in-hospital mortality were measured using the AHRQ Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (2009-2013)...
November 16, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29155341/outpatient-elective-posterior-lumbar-fusions-appear-to-be-safely-considered-for-appropriately-selected-patients
#4
Patawut Bovonratwet, Taylor D Ottesen, Raj J Gala, Daniel R Rubio, Nathaniel T Ondeck, Ryan P McLynn, Jonathan N Grauer
BACKGROUND CONTEXT: There has been growing interest in performing posterior lumbar fusions (PLFs) in the outpatient setting to optimize patient satisfaction and reduce cost. Although still done in only a small percentage of cases, this has been more possible due to advances in surgical techniques and anesthesia. However, data on the perioperative course of outpatient compared to inpatient PLF in a large sample size is scarce. PURPOSE: To compare perioperative complications between outpatient and inpatient PLF in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database...
November 16, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29155253/the-association-of-inflammatory-bowel-disease-and-immediate-postoperative-outcomes-following-lumbar-fusion
#5
Joseph E Tanenbaum, Stephanie T Kha, Edward C Benzel, Michael P Steinmetz, Thomas E Mroz
BACKGROUND CONTEXT: The United States Centers for Disease Control estimates the prevalence of inflammatory bowel disease (IBD) at over 3.1 million people. As diagnostic techniques and treatment options for IBD improve, the prevalence of IBD is expected to increase. For spine surgeons, patients with IBD have a unique complication profile because IBD patients may present with poor nutritional status and because the medications used to manage IBD have been associated with poor vertebral bone mineralization and immunosuppression...
November 15, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29152607/use-of-post-acute-care-after-hospital-discharge-in-urban-and-rural-hospitals
#6
Robert E Burke, Christine D Jones, Eric A Coleman, Jason R Falvey, Jennifer E Stevens-Lapsley, Adit A Ginde
Objectives: Geographic variation in the use of post-acute care (PAC - skilled nursing facility and home health care) after hospital discharge is substantial, but reasons for this remain largely unexplored. PAC use in urban hospitals compared to rural hospitals may be one key contributor. We aimed to describe PAC use, explore substitution of one type of PAC for another, and identify how PAC use varies by diagnosis in urban and rural settings. Study Design: Secondary analysis of the 2012 National Inpatient Sample including adult discharges to PAC after a hospitalization...
March 2017: Am J Accountable Care
https://www.readbyqxmd.com/read/29150530/declining-rates-of-hospitalization-for-selected-cardiovascular-disease-conditions-among-adults-aged-%C3%A2-35-years-with-diagnosed-diabetes-u-s-1998-2014
#7
Nilka Ríos Burrows, YanFeng Li, Edward W Gregg, Linda S Geiss
OBJECTIVE: Reductions in heart attack and stroke hospitalizations are well documented in the U.S. population with diabetes. We extended trend analyses to other cardiovascular disease (CVD) conditions, including stroke by type, and used four additional years of data. RESEARCH DESIGN AND METHODS: Using 1998-2014 National (Nationwide) Inpatient Sample data, we estimated the number of discharges having acute coronary syndrome (ACS) (ICD-9 codes 410-411), cardiac dysrhythmia (427), heart failure (428), hemorrhagic stroke (430-432), or ischemic stroke (433...
November 17, 2017: Diabetes Care
https://www.readbyqxmd.com/read/29146155/a-comparison-of-childbirth-costs-for-adolescents-and-adults-from-2001-to-2010
#8
Smadar Ronen, Jinhyung Lee, Parin Patel, Pooja Patel
PURPOSE: Although teenage birth rates in America have fallen to a historic low of 26.2 births per 1,000 teenagers, the U.S. remains behind the rest of the industrialized world. Adolescent pregnancy is relatively well discussed in today's literature, with ever more detailed estimates constantly emerging to quantify the cost of children born to America's teenagers. This study, however, describes the financial cost of childbirth in the U.S. with a specific focus on understanding the impact of adolescent childbirth in comparison to that of adult women and of annual childbirth as a whole...
November 13, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/29145407/predicting-mortality-and-hospitalization-of-older-adults-by-the-multimorbidity-frailty-index
#9
Yao-Chun Wen, Liang-Kung Chen, Fei-Yuan Hsiao
BACKGROUND: Existing operational definitions of frailty are personnel-costly and time-consuming, resulting in estimates with a small sample size that cannot be generalized to the population level. The objectives were to develop a multimorbidity frailty index using Taiwan's claim database, and to understand its ability to predict adverse event. METHODS: This is a retrospective cohort study. Subjects aged 65 to 100 years who have full National Health Insurance coverage in 2005 were included...
2017: PloS One
https://www.readbyqxmd.com/read/29135667/nationwide-analysis-of-femoral-neck-fractures-in-elderly-patients-a-receding-tide
#10
Derek G Ju, Sean S Rajaee, James Mirocha, Carol A Lin, Charles N Moon
BACKGROUND: Geriatric femoral neck fractures are associated with substantial morbidity and medical cost. We evaluated the incidence and management trends of femoral neck fractures in recent years in the U.S. METHODS: Patient data from 2003 through 2013 were obtained from the Nationwide Inpatient Sample database. Femoral neck fractures in patients ≥65 years old were identified and grouped using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedure codes for internal fixation, hemiarthroplasty, or total hip arthroplasty (THA)...
November 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29129828/contemporary-epidemiology-of-heart-failure-in-fee-for-service-medicare-beneficiaries-across-healthcare-settings
#11
Rohan Khera, Ambarish Pandey, Colby R Ayers, Vijay Agusala, Sandi L Pruitt, Ethan A Halm, Mark H Drazner, Sandeep R Das, James A de Lemos, Jarett D Berry
BACKGROUND: To assess the current landscape of the heart failure (HF) epidemic and provide targets for future health policy interventions in Medicare, a contemporary appraisal of its epidemiology across inpatient and outpatient care settings is needed. METHODS AND RESULTS: In a national 5% sample of Medicare beneficiaries from 2002 to 2013, we identified a cohort of 2 331 939 unique fee-for-service Medicare beneficiaries ≥65-years-old followed for all inpatient and outpatient encounters over a 10-year period (2004-2013)...
November 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29129364/diabetes-control-decreases-morbidity-and-mortality-after-carotid-endarterectomy
#12
Matthew S Parr, Viktor Y Dombrovskiy, Khanjan H Nagarsheth, Randy Shafritz, Saum A Rahimi
BACKGROUND: Single-institution studies have demonstrated a negative effect of diabetes mellitus on outcomes after carotid endarterectomy (CEA). The aim of this study was to compare patients with explicitly controlled and uncontrolled diabetes at the population level. METHODS: Using the National Inpatient Sample 2006-2013, we selected patients undergoing CEA. Rates of stroke, myocardial infarction (MI), and hospital mortality, as well as duration of stay and cost were compared among patients with uncontrolled diabetes (UCDM), well-controlled diabetes (WCDM), and those without diabetes (NDM)...
November 9, 2017: Surgery
https://www.readbyqxmd.com/read/29128581/trends-in-resource-utilization-and-rate-of-cervical-disc-arthroplasty-and-anterior-cervical-discectomy-and-fusion-throughout-the-united-states-from-2006-to-2013
#13
Comron Saifi, Arielle Fein, Alejandro Cazzulino, Ronald Lehman, Frank M Phillips, Howard S An, K Daniel Riew
BACKGROUND CONTEXT: The typically accepted surgical procedure for cervical disc pathology has been the anterior cervical discectomy and fusion (ACDF), although recent trials have demonstrated equivalent or improved outcomes with cervical disc arthroplasty (CDA). Trends for these two procedures regarding utilization, revision procedures, along with other demographic information have not been sufficiently explored. PURPOSE: To provide data regarding ACDF and CDA from 2006-2013 in the U...
November 8, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29127079/effect-of-acupuncture-and-chinese-herbal-medicine-on-subacute-stroke-outcomes-a-single-centre-randomised-controlled-trial
#14
Jianqiao Fang, Crystal Lynn Keeler, Lifang Chen, Ruijie Ma, Chao Wang, Shouyu Xu
OBJECTIVE: To determine whether integrative medicine, combining acupuncture and Chinese herbal medicine with conventional rehabilitation during subacute stroke, is an effective comprehensive rehabilitation strategy for daily life activities, neurological deficits, motor dysfunction, cognitive impairment and depression. DESIGN: Randomised controlled trial: patients were randomly assigned to a conventional rehabilitation (CR) group or an integrative medicine rehabilitation (IMR) group with CR plus acupuncture and Chinese herbal medicine...
November 10, 2017: Acupuncture in Medicine: Journal of the British Medical Acupuncture Society
https://www.readbyqxmd.com/read/29126382/analysis-of-medical-service-use-of-knee-osteoarthritis-and-knee-meniscal-and-ligament-injuries-in-korea-a-cross-sectional-study-of-national-patient-sample-data
#15
Chang Yong Suh, Yoon Jae Lee, Joon-Shik Shin, Jinho Lee, Me-Riong Kim, Wonil Koh, Yun-Yeop Cha, Byung-Cheul Shin, Eui-Hyoung Hwang, Kristin Suhr, Mia Kim, In-Hyuk Ha
BACKGROUND: Osteoarthritis (OA) and meniscal and ligament injuries of the knee are the two most common knee disorders in Korea. The aim of this study was to analyze the demographic characteristics, medical service use and related costs for these disorders, and the results are expected to help inform practitioners, researchers, and policy-makers. METHODS: The present study aimed to evaluate incidence and patient characteristics, and to assess current medical service use, usual care, and medical expenses of knee disorders by analyzing 2014 national patient sample data from the Korean Health Insurance Review and Assessment Service...
November 10, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29126268/duration-of-antibiotic-use-among-adults-with-uncomplicated-community-acquired-pneumonia-requiring-hospitalization-in-the-united-states
#16
Sarah H Yi, Kelly M Hatfield, James Baggs, Lauri A Hicks, Arjun Srinivasan, Sujan Reddy, John A Jernigan
Background: Previous studies suggest duration of antibiotic therapy for community-acquired pneumonia (CAP) often exceeds national recommendations and might represent an important opportunity to improve antibiotic stewardship nationally. The objective of this study was to determine average length of antibiotic therapy (LOT) for patients treated for uncomplicated CAP in US hospitals and proportion of patients with excessive durations. Methods: Records of retrospective cohorts of patients 18-64 years with private insurance and ≥65 years with Medicare hospitalized for CAP in 2012-13 were utilized...
November 6, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29122321/each-procedure-matters-threshold-for-surgeon-volume-to-minimize-complications-and-decrease-cost-associated-with-adrenalectomy
#17
Kevin L Anderson, Samantha M Thomas, Mohamed A Adam, Lauren N Pontius, Michael T Stang, Randall P Scheri, Sanziana A Roman, Julie A Sosa
BACKGROUND: An association has been suggested between increasing surgeon volume and improved patient outcomes, but a threshold has not been defined for what constitutes a "high-volume" adrenal surgeon. METHODS: Adult patients who underwent adrenalectomy by an identifiable surgeon between 1998-2009 were selected from the Healthcare Cost and Utilization Project National Inpatient Sample. Logistic regression modeling with restricted cubic splines was utilized to estimate the association between annual surgeon volume and complication rates in order to identify a volume threshold...
November 6, 2017: Surgery
https://www.readbyqxmd.com/read/29118801/trends-in-endovascular-treatment-of-aneurysmal-subarachnoid-hemorrhages
#18
Tapan Mehta, Neil Datta, Smit Patel, Kathan Mehta, Mohammed Hussain, Inaam Kureshi, Martin Ollenschleger, Amre Nouh
Introduction: Aneurysmal subarachnoid hemorrhage (aSAH) accounts for 5% of all strokes; 30-day mortality is as high as 40%. We sought to evaluate outcomes of aSAH patients treated 2004-2014 by endovascular therapy (EVT), to demonstrate associated trends, and to evaluate angioplasty use for aSAH-related cerebral vasospasm. Methods: The Nationwide Inpatient Sample (NIS) database 2004-2014 was used to derive a study cohort using ICD-9 codes. Survey procedures were used to adjust for stratified cluster design of NIS...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29112666/disparities-in-chronic-conditions-among-women-hospitalized-for-delivery-in-the-united-states-2005-2014
#19
Lindsay K Admon, Tyler N A Winkelman, Michelle H Moniz, Matthew M Davis, Michele Heisler, Vanessa K Dalton
OBJECTIVE: To estimate trends in the prevalence and socioeconomic distribution of chronic conditions among women hospitalized for obstetric delivery in the United States. METHODS: A retrospective, serial cross-sectional analysis was conducted using 2005-2014 data from the National Inpatient Sample. We estimated the prevalence of eight common, chronic conditions, each associated with obstetric morbidity and mortality, among all childbearing women and then across socioeconomic predictors of obstetric outcomes...
November 3, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29112234/impact-of-the-insurance-type-of-head-and-neck-cancer-patients-on-their-hospitalization-utilization-patterns
#20
Avni Gupta, Stephen T Sonis, Eric B Schneider, Alessandro Villa
BACKGROUND: Head and neck cancer (HNC) patients with Medicaid, Medicare, or no insurance show poor outcomes in comparison with privately insured patients. It was hypothesized that nonprivate insurance coverage biases the selection of the treatment site to favor hospitals that are not associated with optimum treatment outcomes. This study assessed the relation between the insurance type of HNC patients and the hospital type for inpatient care. METHODS: Adult HNC patients were identified from the Nationwide Inpatient Sample (2012 and 2013)...
November 7, 2017: Cancer
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